Transcript How we are preventing hospital infections

Improving experience for people with
cancer in Croydon
Presentation on the finding of the national cancer patient
survey 2012-13
Claudia Tomlinson
Jackie Green
Tuck Kay Loke
How cancer services are organised at CHS
• CHS is part of the London Cancer Alliance
.
• Partnership with LCA, Macmillan Cancer Relief etc.
• Cancer and Core Functions Directorate (CCF)
• CAB, Macmillan Information Centre, Counselling &
complimentary services
Type
Treatment
Cancer Centre
Breast
Surgery
Chemotherapy & Radiotherapy at RMH
Colorectal
Surgery
Chemotherapy & Radiotherapy at RMH
Dermatology
Surgery
Complex surgery requiring plastic at ST Georges
Gynaecology
Diagnostic & Low risk endometrial surgery
Chemotherapy, radiotherapy and surgery at RMH
Haematology
Level II service
Level III and Level IV at RMH
Lung
Diagnostics and Palliative Care and follow
up for radiotherapy
Chemotherapy at RMH and surgery at St Georges.
Paediatrics
POSCU Levl1
GOS and RMH
Urology
Surgery and Bladder chemotherapy
Radiotherapy at RMH/Complex surgery at St Georges.
Upper GI
Diagnostics
Surgery at RMH
Executive Lead
for Cancer COO
Clinical Director for
CCF
Clinical Lead for
Cancer
Site Specific
Clinical Leads
General
Manager
Nurse
Consultant/Lea
d Cancer Nurse
Cancer
Manager
Cancer Nursing
Team
Cancer Admin
Team
Background and context
National Cancer Patient Experience Survey 2012/13 CHS
•
Annual survey undertaken by Quality Health
•
All patients 16 + who had received treatment for cancer during September –
November 2012 are eligible
•
National number of patients included 116,525. Average national response rate
was 64% .
•
CHS number of patients included 66 with a 68% (44 patients) response rate
•
Trusts are ranked in top 20% and lower 20% in all questions and the
intermediate group 60%
Survey methodology
2010/11
2011/12
2012/13
Sample month
01 Jan – 31 March
2010
01 Sept – 30
November 2011
01 Sept – 30
November 2012
Sample size (eligible
patients)
199
81
66
Responses
103
50
44
Response rate
58%
66%
68%
Changes since
the survey
began:
Sampling month
Sample size
Reducing
number of
responses
Response rate
stable over two
years
Survey methodology - respondents
Top 5 Tumour group respondents
Tumour Group
2010/11
2011/12
2012/13
Breast
18
19
20
Colorectal/Lower GI
20
12
11
Haematological
19
10
6
Urological
22
Lung
6
5
Survey methodology sampling issues
for CHS
• Low numbers of eligible patients identified on
PAS
• Possible sampling issues due to difficulty in
identifying cancer patients
• Information services rely on clinical service to
identify cancer patients by diagnosis
Last 3 years results
2010 / 11 CHS in bottom 10 in the country
x 35 fell in bottom 20% and 4 x in top 20%
2011/ 12 CHS no longer in the bottom 10
X 21 fell in bottom 20% and 19 in top %
2012/13 CHS in bottom 10 in the country
x 38 fell in bottom 20% and 4 x in top 20%
1 of the 9 London Trusts in the bottom 10
Questions rated in top 20% (‘green’ rated)
No
Question
Score
11
Patient told could bring a friend
81%
13
Patient completely understood what was wrong
81%
19
Patient told how treatment side effects could affect
them in the future
62%
63
GP given enough information about patient's
condition/treatment
100%
Questions improved since last survey
No.
6
11
13
16
20
28
44
47
48
49
55
63
64
Table 2: Summary of thirteen indicators showing
improvement in 2012/13
Staff explanation purpose of tests
Patient told could bring a friend
Patient completely understood what was wrong
Patient's views taken into account/treatment
Patients involved in decisions about care and treatment
Patient informed they could get free prescriptions
Enough nurses on duty
Staff asked patient name they preferred to be called by
Privacy when discussing treatment/condition
Privacy when examined/treated
Family given information to help care at home
GP given enough information about patient's
condition/treatment
Practice staff did everything they could to support patient
CHS
2012/13
Score
(%)
76%
81%
81%
Highest
Trust’s
score
2012/13
93%
89%
85%
69%
76%
84%
85%
70%
37%
31%
83%
88%
89%
84%
96%
92%
58%
100%
100%
77%
100%
64%
82%
Questions significantly worsened since last survey
No
Table 3: Specific indicators significantly worsened in
2012/13
2
CHS
Score
2011/1
2
88%
CHS
Score
2012/13
90%
73%
62%
31%
87%
64%
96%
70%
89%
64%
68%
Patient thought seen as soon as possible
4
Patient health the same/better while waiting
30
Discussing taking part in cancer research with patient
35
Staff explained how the operation had gone
67
Given the right amount of information about condition/treatment
70
Patient rating of care 'excellent/very good'
Key Actions
No
Period
Action
Lead
Deadline
1
S
Disseminate survey results to all
directorates and key forums in
CHS
Clinical Lead for Cancer
& Lead Cancer Nurse
December 2013
2
S
Meet the CNS team posters
CNS/Keyworker business cards
Lead Cancer Nurse
December 2013
3
S
December 2013
4
S
Root Cause Analysis exercise to Lead Cancer Nurse
be conducted using the 5 Whys
& General Manager
technique
All patients with cancer have
Lead Cancer Nurse
access to a CNS/ key worker and
Holistic Needs Assessment business case developed to
facilitate
5
S
Deliver a listening event with
stakeholders
January 2014
Clinical Lead for Cancer
& Lead Cancer Nurse
December
2013
Key Actions
No
Period
Action
Lead
Deadline
6
M
Providing financial advice Continuation General Manager
of partnership working with Croydon
and Lead Cancer
CAB service funded for 1 more year.
Nurse
Requires sustainability plan and pick
up funding from October 2014
June 2014
7
M
Responding to patient feedback
(including real time)
Clinical Lead for
Cancer & Lead
Cancer Nurse
April 2014
8
L
Work with Macmillan and the London
Cancer Alliance pathway groups in
improving the patient experience
Clinical Lead for
September
Cancer Lead
2014
Cancer Nurse
& Cancer Manager
9
L
Taking Patients views into account –
implementing action from the listening
event
10
L
To review expanding the cancer and
palliative care nursing service
Clinical Lead for
Cancer Lead
Cancer Nurse
& Cancer Manager
Lead Cancer Nurse
September
2014
September
2014
Summary
• Picture of findings of cancer patient experience for past
three years presented, showing fluctuating performance
• Methodological issues discussed including identification
and sampling of patients
• Although an overall worsening since last survey, there is
evidence of good performance in many areas
• Improvement actions will focus on:
 Listening to patients and stakeholders
 Sharing and learning from the results
 Promote a multidisciplinary response